更改

一项针对TRD和OCD的系统回顾发现了23例DBS, 9例为OCD, 7例为TRD, 1例为两者。“大约一半的患者确实表现出了显著的改善”，而且考虑到精神病患者的年龄相对于运动障碍患者的年龄，不良事件“通常微不足道”<ref name=Lakhan>{{cite journal|vauthors = Lakhan SE, Callaway E|title = Deep brain stimulation for obsessive-compulsive disorder and treatment-resistant depression: systematic review|journal = BMC Research Notes|volume = 3|issue = 1|pages = 60|date = March 2010|pmid = 20202203|pmc = 2838907|doi = 10.1186/1756-0500-3-60}}</ref>。在第一个随机对照研究中，DBS用于治疗以腹侧囊/腹侧纹状体区域为靶点的TRD，在16周的研究结束时，active组和sham组之间的缓解率没有显著差异<ref name=":29">{{cite journal|vauthors = Dougherty DD, Rezai AR, Carpenter LL, Howland RH, Bhati MT, O'Reardon JP, Eskandar EN, Baltuch GH, Machado AD, Kondziolka D, Cusin C, Evans KC, Price LH, Jacobs K, Pandya M, Denko T, Tyrka AR, Brelje T, Deckersbach T, Kubu C, Malone DA|title = A Randomized Sham-Controlled Trial of Deep Brain Stimulation of the Ventral Capsule/Ventral Striatum for Chronic Treatment-Resistant Depression|journal = Biological Psychiatry|volume = 78|issue = 4|pages = 240–48|date = August 2015|pmid = 25726497|doi = 10.1016/j.biopsych.2014.11.023|s2cid = 22644265}}</ref>。然而，另一项腹侧胶囊DBS治疗TRD的随机对照研究确实表明，有效DBS(有效率为44%)和假DBS(有效率为0%)的缓解率存在显著差异)<ref name=":30">{{cite journal|vauthors = Bergfeld IO, Mantione M, Hoogendoorn ML, Ruhé HG, Notten P, van Laarhoven J, Visser I, Figee M, de Kwaasteniet BP, Horst F, Schene AH, van den Munckhof P, Beute G, Schuurman R, Denys D|display-authors = 6|title = Deep Brain Stimulation of the Ventral Anterior Limb of the Internal Capsule for Treatment-Resistant Depression: A Randomized Clinical Trial|journal = JAMA Psychiatry|volume = 73|issue = 5|pages = 456–64|date = May 2016|pmid = 27049915|doi = 10.1001/jamapsychiatry.2016.0152|doi-access = free}}</ref>。DBS治疗强迫症疗效显著，重症和难治性患者平均有效率为60%<ref name=":31">{{cite journal|vauthors = Alonso P, Cuadras D, Gabriëls L, Denys D, Goodman W, Greenberg BD, Jimenez-Ponce F, Kuhn J, Lenartz D, Mallet L, Nuttin B, Real E, Segalas C, Schuurman R, du Montcel ST, Menchon JM|display-authors = 6|title = Deep Brain Stimulation for Obsessive-Compulsive Disorder: A Meta-Analysis of Treatment Outcome and Predictors of Response|journal = PLOS ONE|volume = 10|issue = 7|pages = e0133591|date = 2015-07-24|pmid = 26208305|pmc = 4514753|doi = 10.1371/journal.pone.0133591|bibcode = 2015PLoSO..1033591A|doi-access = free}}</ref>。根据这些结果，美国食品和药物管理局(FDA)根据人道主义器械豁免(HDE)批准了DBS治疗顽症，要求只有在有专业资格的医院才能实施该手术。

一项针对TRD和OCD的系统回顾发现了23例DBS, 9例为OCD, 7例为TRD, 1例为两者。大约一半的患者确实表现出了显著的改善，而且考虑到精神病患者的年龄相对于运动障碍患者的年龄，不良事件通常微不足道<ref name=Lakhan>{{cite journal|vauthors = Lakhan SE, Callaway E|title = Deep brain stimulation for obsessive-compulsive disorder and treatment-resistant depression: systematic review|journal = BMC Research Notes|volume = 3|issue = 1|pages = 60|date = March 2010|pmid = 20202203|pmc = 2838907|doi = 10.1186/1756-0500-3-60}}</ref>。在第一个随机对照研究中，DBS用于治疗以腹侧囊/腹侧纹状体区域为靶点的TRD，在16周的研究结束时，active组和sham组之间的缓解率没有显著差异<ref name=":29">{{cite journal|vauthors = Dougherty DD, Rezai AR, Carpenter LL, Howland RH, Bhati MT, O'Reardon JP, Eskandar EN, Baltuch GH, Machado AD, Kondziolka D, Cusin C, Evans KC, Price LH, Jacobs K, Pandya M, Denko T, Tyrka AR, Brelje T, Deckersbach T, Kubu C, Malone DA|title = A Randomized Sham-Controlled Trial of Deep Brain Stimulation of the Ventral Capsule/Ventral Striatum for Chronic Treatment-Resistant Depression|journal = Biological Psychiatry|volume = 78|issue = 4|pages = 240–48|date = August 2015|pmid = 25726497|doi = 10.1016/j.biopsych.2014.11.023|s2cid = 22644265}}</ref>。然而，另一项腹侧胶囊DBS治疗TRD的随机对照研究确实表明，有效DBS(有效率为44%)和假DBS(有效率为0%)的缓解率存在显著差异)<ref name=":30">{{cite journal|vauthors = Bergfeld IO, Mantione M, Hoogendoorn ML, Ruhé HG, Notten P, van Laarhoven J, Visser I, Figee M, de Kwaasteniet BP, Horst F, Schene AH, van den Munckhof P, Beute G, Schuurman R, Denys D|display-authors = 6|title = Deep Brain Stimulation of the Ventral Anterior Limb of the Internal Capsule for Treatment-Resistant Depression: A Randomized Clinical Trial|journal = JAMA Psychiatry|volume = 73|issue = 5|pages = 456–64|date = May 2016|pmid = 27049915|doi = 10.1001/jamapsychiatry.2016.0152|doi-access = free}}</ref>。DBS治疗强迫症疗效显著，重症和难治性患者平均有效率为60%<ref name=":31">{{cite journal|vauthors = Alonso P, Cuadras D, Gabriëls L, Denys D, Goodman W, Greenberg BD, Jimenez-Ponce F, Kuhn J, Lenartz D, Mallet L, Nuttin B, Real E, Segalas C, Schuurman R, du Montcel ST, Menchon JM|display-authors = 6|title = Deep Brain Stimulation for Obsessive-Compulsive Disorder: A Meta-Analysis of Treatment Outcome and Predictors of Response|journal = PLOS ONE|volume = 10|issue = 7|pages = e0133591|date = 2015-07-24|pmid = 26208305|pmc = 4514753|doi = 10.1371/journal.pone.0133591|bibcode = 2015PLoSO..1033591A|doi-access = free}}</ref>。根据这些结果，美国食品和药物管理局(FDA)根据人道主义器械豁免(HDE)批准了DBS治疗顽症，要求只有在有专业资格的医院才能实施该手术。

DBS治疗TRD与抗抑郁药一样有效，有良好的反应率和缓解率，但不良反应和安全性必须得到更全面的评估。常见的副作用包括“伤口感染、围手术期头痛、情绪恶化/烦躁以及自杀倾向增加”<ref name=Moreines>{{cite journal|vauthors = Moreines JL, McClintock SM, Holtzheimer PE|title = Neuropsychologic effects of neuromodulation techniques for treatment-resistant depression: a review|journal = Brain Stimulation|volume = 4|issue = 1|pages = 17–27|date = January 2011|pmid = 21255751|pmc = 3023999|doi = 10.1016/j.brs.2010.01.005}}</ref>。

DBS治疗TRD与抗抑郁药一样有效，有良好的反应率和缓解率，但不良反应和安全性必须得到更全面的评估。常见的副作用包括伤口感染、围手术期头痛、情绪恶化/烦躁以及自杀倾向增加<ref name=Moreines>{{cite journal|vauthors = Moreines JL, McClintock SM, Holtzheimer PE|title = Neuropsychologic effects of neuromodulation techniques for treatment-resistant depression: a review|journal = Brain Stimulation|volume = 4|issue = 1|pages = 17–27|date = January 2011|pmid = 21255751|pmc = 3023999|doi = 10.1016/j.brs.2010.01.005}}</ref>。

<br>

<br>